EFFECT OF TREADMILL WALKING VERSUS STATIONARY CYCLING ON PAIN, TRANSVERSUS ABDOMINIS ENDURANCE, DISABILITY & QUALITY OF LIFE IN NON-SPECIFIC CHRONIC LOW BACK PAIN: A QUASI EXPERIMENTAL STUDY

Abstract

Background: Diminished muscular performance & greater functional impairment leads to restricted quality of life in chronic low back pain (CLBP) patients. The transverses abdominis (TrA) has been implicated as part of the cause of LBP. The purpose of the study was to compare the effects of treadmill walking and stationary cycling in subjects with non-specific CLBP. Methodology: A quasi-experimental study was conducted with 30 subjects divided into 2 groups. Group A consisted of treadmill walking & group B of cycling. Subjects aged 18 to 45 years with chronic LBP without radiating pain with absence of any cardiac & pulmonary conditions were included. Moderate intensity aerobic exercise for 10-20 minutes, 5 days/week based on FITT principle was given. Outcome measures were pain, TrA endurance, disability & quality of life. Results: Statistically significant difference (p<0.001) was noted for all outcome measures in both groups A & B with non-significant difference (p>0.05) between groups. For Group A, NRS (Numerical Rating Scale) at rest (95% CI 2.182 to 3.685), NRS on activity (95% CI 3.056 to 4.410), TrA endurance (95% CI -3.61 to -2.79), MODI (Modified Oswestry Disability Index) (95% CI 20.05 to 29.01), physical health (95% CI -18.80 to -9.33) & overall QOL of WHOQOL (95% CI -2.06 to -1.26). For Group B, NRS at rest (95% CI 2.034 to 3.699), NRS on activity (95% CI 2.214 to 4.186) & TrA endurance (95% CI -4.78 to -2.01), MODI (95% CI 21.75 to 31.04), physical health (95% CI -23.36 to -10.77) & overall QOL of WHOQOL (95% CI -2.32 to -1.27). Conclusion: Treadmill walking & stationary cycling were equally effective in improving pain, TrA endurance, disability & quality of life in subjects with non-specific CLBP. Clinical Implication: Aerobic exercise such as walking & cycling at moderate intensity can be used to reduce pain & disability & increase core muscle (transversus abdominis) endurance thereby improving quality of life in patients with CLBP.

The effectiveness of different aerobic exercises to improve pain intensity and disability in chronic low back pain patients: a systematic review

“…The duration of included studies' intervention was between 4 weeks 45 and 12 months. 46 Among these, eleven studies followed up for short term (<3 months or 12 weeks), 45,[47][48][49][50][51][52][53][54][55][56] eleven studies followed up for intermediate-term (3 months to <12 months) 43,44,[46][47][48]52,53,[56][57][58][59] and two studies followed up for long term (≥12 months). 46,55 Studies examined the effectiveness of different types of AE.…”

“…46,55 Studies examined the effectiveness of different types of AE. Eleven studies evaluated the effectiveness of different forms of AE alone [43][44][45][46][47]49,54,[56][57][58] while seven studies examined AE in conjunction with other intervention including stabilization exercise, 47 back school program, 50 rehabilitation program, 51 group exercise class, 52 traditional physiotherapy 55 and home exercise. 48 Table 1.…”

“…As an intervention, ten studies used walking exercise [45][46][47][48][49]51,53,54,58 ; three studies used stationary cycling exercise 45,50,52 ; one study used treadmill running exercise 57 ; one study used both walking and running exercise 43 ; one study used combined treadmill walking, stair climbing and stationary cycling exercise 59 ; one study used walking and jogging exercise with elliptical trainer 56 ; one study used individually designed and supervised aerobic exercise. 55 In this review, we focused on the improvement in pain intensity and functional disability.…”

“…To measure pain intensity, nine studies used the Visual Analogic Scale (VAS), 43,[47][48][49]51,52,55,56,59 six studies used Numerical Pain Rating Scale (NRS), [44][45][46]50,53,58 one study used McGill Pain Questionnaire (MPQ) 57 and one study did not measure pain intensity. 54 Functional disability was evaluated by using Oswestry Low Back Pain Disability Index (ODI, 0-100) in eleven studies, [43][44][45]47,49,[52][53][54]56,58,59 Oswestry Low Back Pain Disability Index (ODI,10-60) in one study, 51 Roland and Morris Disability Questionnaire (RMDQ) in four studies 46,48,50,57 and Aberdeen Low Back Pain Disability Scale (ALBPS) in one study. 55 Risk of bias and quality assessment of studies Quality assessment of included studies using the PEDro scale is shown in Table 2, which demonstrated that the range of the scores was between 4/10 and 8/10 (mean 6.…”

“…35 AE 1.46). Two studies scored the minimum (4/10), 45,51 while five studies reached the best possible score (8/10). 49,[52][53][54]58 Eleven studies obtained the threshold score (6/10) to be considered a good quality study.…”